HealthDay News — Among ST-segment elevation myocardial infarction (STEMI) patients who could be treated in an intensive care unit (ICU) or a non-ICU unit, those treated in the ICU have improved mortality rates, according to a study published online June 4 in The BMJ.
Thomas S. Valley, MD, from the University of Michigan in Ann Arbor, and colleagues evaluated the effect of ICU admission on mortality among 109,375 Medicare beneficiaries (≥65 years) with STEMI vs admission to a non-ICU unit (general/telemetry ward or intermediate care).
The researchers found that hospitals in the top quarter of ICU admission rates admitted ≥85% of STEMI patients to an ICU. ICU admission was associated with lower 30-day mortality rates compared with non-ICU admission (absolute decrease 6.1 percentage points; 95% confidence interval, −11.9 to −0.3) among patients who received ICU care dependent on their proximity to a hospital in the top quarter of ICU admission rates. Among patients with non-STEMI, ICU admission was not associated with differences in mortality (absolute increase, 1.3 percentage points; 95% confidence interval, −0.9 to 3.4), in line with previous evidence.
“An urgent need exists to identify which patients with STEMI benefit from ICU admission and what about ICU care is beneficial,” the authors write.